Healthcare Provider Details

I. General information

NPI: 1770217051
Provider Name (Legal Business Name): KAITLYN MARIE SCHWENGER MSN, CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 ROUTE 70
LAKEWOOD NJ
08701-5897
US

IV. Provider business mailing address

121 KENSINGTON DR
GALLOWAY NJ
08205-4678
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-8000
  • Fax:
Mailing address:
  • Phone: 609-289-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00078500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00078501
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: